Researchers presenting new studies at the annual meeting of the American Academy of Allergy, Asthma and Immunology in Miami Beach have recorded associations between maternal nutrition and stress with asthma in children.

One study found that expectant mothers who take higher amounts of vitamin D may decrease their child's risk for asthma.

Vitamin D deficiency is common in areas where asthma is also widespread, raising the suspicion that the two are linked, said Dr. Carlos Camargo, senior author of the study and an associate professor of medicine and epidemiology at Harvard Medical School in Boston.

Camargo and his team followed 1,300 mother-child pairs for more than three years.

By the time the children were 2 years old, there was already a clear association between higher vitamin D intake when the mother was pregnant and lower risk of wheezing and asthma in the children, he said at a news conference Saturday in Miami Beach.

And, he added, the three-year link was even stronger.

The results of previous studies suggest that vitamin D may have an effect on a fetus's developing immune system.

"Doctors should understand that vitamin D insufficiency is real," Camargo said. "It's important to get it from diet or supplements and the way to do that is through fortified milk, fish and supplements. And that is totally independent of our findings."

A Canadian study found that pregnant women who have asthma are more likely to have premature babies and to have babies with low birth weight.

This survey of 13,980 children born in Manitoba found that mothers who suffered from asthma were, on average, 2.77 times more likely to have a baby born at less than 28 weeks' gestation and 3.04 times more likely to have a baby born at less than 32 weeks' gestation than a non-asthmatic mother.

"Maternal asthma is a risk factor for prematurity and low birth weight in babies, and physicians and other health-care professionals need to assess present and past asthma even up to five years prior in order to properly assess risk for premature labor," said lead author Dr. Joel Liem, a research fellow in pediatric allergy and clinical immunology at the University of Manitoba.

Another research group at the same university found that children of mothers who experienced stress (defined as visiting a doctor or getting a prescription for depression or anxiety) were 1.3 times more likely to develop asthma. "The highest risk was in children with repeat exposure to mother's stress," said Anita Kozyrskyj, lead author of the study and associate professor of pharmacy and medicine at the university.

Kozyrskyj could only speculate on the possible mechanisms behind this association. "It may be related to the fact that stress alters mom's behavior, and there is some evidence that stress in the first year of life can cause some changes to the gastrointestinal system," she said.

Asthma affects more than 18 million people in the United States, with total direct medical expenditures reaching into the billions.

Not surprisingly, researchers are fast in the pursuit of causes as well as better ways to treat the disease.

Other studies presented this week in Miami Beach found that children and parents of children were under-reporting how much asthma medication the child was taking. By one measure, only one-third of the medicine was actually being used.

The study was undertaken to try to understand why people don't adhere to medication guidelines.

"Most patients don't follow daily treatment regimens no matter how good their doctor is," said Bruce Bender, lead author and head of pediatric behavioral health at National Jewish Medical and Research Center in Denver. "That disconnect is huge, and it's a large factor in how well we control asthma in kids and adults."

Finally, another study done at the VA Greater Los Angeles Healthcare System found that patients with intermittent (as opposed to persistent) asthma accounted for nearly half of all asthma-related emergency department visits.

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